Neurodevelopmental outcome in congenital diaphragmatic hernia survivors: role of ventilatory time

BackgroundNeurodevelopmental impairment is one of the most significant morbidities among CDH survivors.PurposeAssess correlation between ventilatory time (VT) and short-term neurodevelopmental outcome in congenital diaphragmatic hernia (CDH) survivors.MethodsA prospective longitudinal study was conducted between 2008 and 2012. Assessment of mental and motor development was performed at 6 and 12 months by Bayley Scales of Infant and Toddler Development — 3rd Edition (BSID-III). ROC curve analysis was used.ResultsForty-two subjects were included in the study. There was a significant inverse correlation between neurodevelopment at 6 and 12 months and VT during first admission (p < 0.0001). VT predicting the risk of moderate (BSID-III < 85) and severe (BSID-III < 70) delay was 13 and 28 days, respectively (area under the curve — delay < 85: 6 months mental 0.943 and motor 0.992; 12 months mental 0.877 and motor 0.925; delay < 70: 6 months mental 0.934 and motor 0.943; 12 months mental 0.906 and motor 0.975; p < 0.0001).ConclusionsVT should be considered an important marker to identify subjects at risk for short-term neurodevelopmental delay in CDH survivors. Early follow-up intervention therapy should be activated in every baby with a history exceeding 13 days of VT.